1,721,014 research outputs found
Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists for preventing the progression of diabetic kidney disease
No full textBackground: Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor antagonists (AIIRA) are considered to be equally effective for patients with diabetic kidney disease (DKD), but renal and not mortality outcomes have usually been considered. Objectives: To evaluate the benefits and harms ACEi and AIIRA in patients with DKD. Search strategy: We searched MEDLINE (1966 to December 2005), EMBASE (1980 to December 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 4 2005) and contacted known investigators. Selection criteria: Studies comparing ACEi or AIIRA with placebo or each other in patients with DKD were included. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Statistical analyses were performed using the random effects model and results expressed as relative risk (RR) with 95% confidence intervals (CI). Heterogeneity among studies was explored using the Cochran Q statistic and the I2 test, subgroup analyses and random effects metaregression. Main results: Fifty studies (13,215 patients) were identified. Thirty eight compared ACEi with placebo, five compared AIIRA with placebo and seven compared ACEi and AIIRA directly. There was no significant difference in the risk of all-cause mortality for ACEi versus placebo (RR 0.91, 95% CI 0.71 to 1.17) and AIIRA versus placebo (RR 0.99, 95% CI 0.85 to 1.17). A subgroup analysis of studies using full-dose ACEi versus studies using half or less than half the maximum tolerable dose of ACEi showed a significant reduction in the risk of all-cause mortality with the use of full-dose ACEi (RR 0.78, 95% CI 0.61 to 0.98). Baseline mortality rates were similar in the ACEi and AIIRA studies. The effects of ACEi and AIIRA on renal outcomes (ESKD, doubling of creatinine, prevention of progression of micro-to macroalbuminuria, remission of micro- to normoalbuminuria) were similarly beneficial. Reliable estimates of effect of ACEi versus AIIRA could not be obtained from the three studies in which they were compared directly because of their small sample size. Authors' conclusions: Although the survival benefits of ACEi are known for patients with DKD, the relative effects on survival of ACEi with AIIRA are unknown due to the lack of adequate direct comparison studies. In placebo controlled studies, only ACEi (at the maximum tolerable dose, but not lower so-called renal doses) were found to significantly reduce the risk of all-cause mortality. Renal and toxicity profiles of these two classes of agents were not significantly different. Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd
Evidence for optimal hemoglobin targets in chronic kidney disease
No full textEven though anemia occurs frequently in patients with chronic kidney disease and therapeutic options are widely available, the ideal hemoglobin target level is not clearly established. We start from 2 anecdotes and review the evidence in favor of and against higher (> 12 g/dL) and normal hemoglobin targets as compared to subnormal or low hemoglobin levels in different subsets of chronic kidney disease (either predialysis or dialysis). Current clinical trials and their systematic reviews have found that higher hemoglobin levels (> 12 g/dL) do not significantly impact on patient-level cardiovascular end points including cardiovascular and all-cause mortality. Patients feel better, and enhanced quality of life parameters have been identified in most short-term studies when higher hemoglobin levels are achieved. However, achieving and maintaining higher hemoglobin levels carry the risk of hypertension and vascular access thrombosis in dialysis patients and are costly. In addition, a potential for increased risk of death (or no benefit at most) with higher Hb levels has been found in patients with severe cardiac disease in a larger trial. Benefits of and harm from hemoglobin targets should be carefully weighed, and certainly more, proper studies are needed before higher hemoglobin levels (> 12 g/dL) are widely adopted in these high-risk patients
Rituximab induces complete remission in a case of membranous nephropathy associated with hepatitis C virus- related infection
No full text
Desmopressin acetate in percutaneous ultrasound-guided kidney biopsy: a randomized controlled trial
Full text linkBleedingcomplications occur in one-third of percutaneous kidney biopsies and increase costs of the hospital stay. The aimofthestudywastoevaluatetheeffectofprebiopsyadministrationofdesmopressin acetate versus placebo in the incidence of postbiopsy bleeding complications
Evidence-based guidelines and nephrological clinical practice: the GRADE system for rating of evidence
No full textAntihypertensive agents for primary prevention of diabetic nephropathy: With focus on renal outcomes, is it proven that any agent is equivalent, as long as blood pressure control is tight?
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
